Syncing with Tellus / Netsmart
Tellus Sync Status Window
Daily management of shifts and EVV is essential to successful medicaid billing. The Tellus Sync Status window should be referenced daily to help identify and resolve issues.
Go to the main File menu > Tellus Sync Status
This window displays the current status of visits in the system that are submitted or will be submitted to Tellus.
It also displays whether shifts are Invalid (they have a problem which prevents them from being sent to Tellus) or Rejected (we attempted to send the shift to Tellus but there was a problem).
The process for fixing rejected shifts is for the agency to fix the data, hit the Clear Rejections button, then sync (or wait for the auto-sync) to send the visit again.
Shifts that are scheduled up to 1 day in the future are included.
Each of the Tellus Shift Status buttons will take you to a corresponding shift list.
- Up to Date: These shifts have synced to Tellus and match between Rosemark and the Tellus portal.
- To be Added: Ready to be synced with Tellus, but not yet sent.
- To be Updated: Changes have been made to previously synced shifts and need to be updated in the Tellus Portal.
- In Process: Currently syncing.
- INVALID: Exceptions on shifts that prevent them from syncing to Tellus - See ‘Shift Exceptions and Reason codes’ section below on how to address these issues.
- REJECTED: These shifts have been sent to Tellus, but were rejected due to configuration issues - See ‘Rejections’ section below on how to address these issues.
Shift Exceptions and Reason Codes
Exceptions appear in the Medicaid Status tab on individual Medicaid Shifts. Exceptions can be acknowledged/resolved (and a reason code applied) after a shift has been synced to Tellus; however, reason codes are only submitted to Tellus once the shift is marked Complete.
Rosemark displays the following exceptions:
- Missing Clock In / out - add a manual EVV event to resolve
- Clock-In/out was Early/Late - adjust shift times to resolve.
NOTE: Rosemark sends the original scheduled times to Tellus, so changing the shift times does not affect whether or not the caregiver is considered on-time or late or early -- it only explains why to Tellus. Once a shift has a clock-in, the original schedule is locked in Tellus and cannot be updated after the fact.
The following exceptions can be resolved by “acknowledgment”:
- EVV Times Do Not Match Shift - If a shift’s EVV start time or end time is more than two hours later than the scheduled start time or end time, this exception will appear.
- Event from Non-Client Phone - The caregiver called from a phone other than the client phone.
- Clock-In/Out Location Other than Scheduled - This is a GPS distance issue, and must be acknowledged
NOTE: These are the exceptions we understand are necessary to resolve before claims may be processed; if you encounter any exceptions not covered by this list in the Tellus portal, please let Rosemark support know what they are and what reason codes are provided as options to resolve those exceptions as exceptions may change over time.
Rejections
Rosemark may display rejections. If you are unsure how to handle any rejections please contact Rosemark support. Below is an example list of rejections:
- Procedure Code Not Configured
This means that the correct procedure code has not been set up on the service type. Review the procedure code list here
- Recipient-Does-Not-Exist-In-System
This means either the Date of Birth or the Recipient MedicaidId value(s) do not match the records received by the Payer in our database.
- Provider-Does-Not-Exist-In-System
This means either the ProviderEIN or the ProviderMedicaidID value(s) do not match any Provider records in the Payer database.
How to clear Rejections:
- First, click on the Rejection listed in the Tellus Sync window, and click the ‘ View Shifts button’ to see which client/shifts are affected.
- Update/edit or add the missing or invalid fields, referencing the list above.
- Once updated, click the ‘ Clear Rejections’ button.
- If rejections are not corrected the Rejections error will reappear upon the next hourly sync with Tellus.
Scheduling
Overnight Shifts
We recommend agencies split overnight shifts at midnight. This can be done on a shift-by-shift basis or the on-going schedule can be updated to automatically include midnight shift splits.
Splitting shifts at midnight is not necessary but it is recommended.
Canceling a Shift
There are many reasons you may need to cancel a shift that has been synced to Tellus:
- Client cancels
- Employee cancels and no replacement can be found
- Client reschedules for a different day
Etc.
In Rosemark be sure to change the status of the shift to the appropriate cancelation status. You will then be prompted to enter a reason and action taken code and that information will be updated in Tellus for the shift in question.
Shifts scheduled further than 48 hours in advance will not currently require any reason codes for Shift Exceptions and Reason Codes cancellation.
Pre-Claims and Completing Shifts
Once a shift is deemed ready for billing, the agency can mark the shift Complete, using the Pre-claims functionality. “Complete” in Tellus is not the same as Verified Complete in Rosemark. Only Verified Complete shifts in Rosemark can be marked ’Complete’ for Tellus. ‘Completing’ a shift for Tellus LOCKS the shifts from further changes in Rosemark and allows that shift to be billed to Medicaid in Tellus.
Marking Shifts ‘Complete’ using our Pre-claims functionality is the first step in your new billing process.
Marking a shift “Complete” (Pre-Claims)
First, be sure to address any and all exceptions on a shift before creating Pre-claims. When you’re confident that shifts are ready to be billed go to the Office menu on the main Rosemark window > Create Pre-Claims.
Like invoicing in Rosemark, you do NOT need to select a start date for the Pre-Claim, only a through date. This should be the last day of your normal billing cycle. You will not be able to create Pre-Claims for shifts that have not happened yet.
After choosing the through date at the top, select the clients you wish to bill by checking the box next to their names. This will create a Pre-Claim for that client.
Once created, Pre-claims will have up to 4 different statuses:
- All shifts ready to Complete
- Some shifts not ready to Complete
- No shifts ready to Complete
- All shifts Completed.
You can filter the list by date range or by Status.
Any shifts marked as ‘Not Ready to Complete’ need to have exceptions addressed under the Medicaid Status tab on each shift.
Click on the Pre-claim, then the Not Ready to Complete list under the Summary section. Then, double click on an individual shift to open it. Go to the Medicaid Status tab on the shift. Clear any exceptions or add manual EVV as necessary.
Once all exceptions for the shift have been handled, you will see it move from ‘Not Ready to Complete’ to ‘Ready to Complete’.
Now, you can check the box next to the shift and Click the ‘Mark Shifts Completed’ button at the bottom of the Pre-Claim. You may select each shift or all shifts with the ‘Select all’ checkbox.
Please keep in mind that shifts marked as ‘Completed’ on Pre-Claims will be LOCKED in Rosemark from any further changes. Only mark shifts Complete when you are sure they are correct and ready for billing to Medicaid.
Once all shifts on a Pre-claim have been marked as Complete the Status of the Pre-claim will change to Finalized. You are now ready to go into the Tellus portal and send these items to Medicaid for reimbursement!
Other things to note:
Pre-claims do not have to be Completed all at once. If you need to you can log out of Rosemark and come back later. Just go to Office > Pre-Claims List to reopen the Pre-claims you were working on, or to review Pre-Claims you have already finalized.
Resources
If you need any help or have questions about Rosemark set up, data entry or Pre-claims for the Tellus EVV integration please contact Rosemark Customer Care at:
For Issues unrelated to transfer of data (i.e. use of Tellus portal, remediating visits in the worklist, claims issues, etc), agencies should contact the Georgia EVV Call Center at:
Phone: 833-701-0012
Email: GAEVVSupport@Conduent.com
Website for Chat: www.GAEVV.com